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Summary
Discoid lupus erythematosus (sometimes referred to as DLE) is an autoimmune disease that affects the skin. It is one of the most common immune diseases of the skin in dogs. Autoimmune diseases happen when the immune system, which normally protects the body from illnesses, attacks healthy tissues or cells. While we do not know what causes DLE, skin issues associated with it get worse with sun exposure.
Systemic lupus erythematosus is a similar disease, but it is more severe and affects many other organs within the body.
Symptoms and Identification
Symptoms of discoid lupus erythematosus are primarily related to the hairless portion of a dog’s nose. The nose will change color, ulcerate, ooze, and/or develop a crusty appearance. Nosebleeds may also occur.
Sometimes the skin around the eyes will be affected as well. Hairy portions of a dog can also be affected, but this is not common.
Biopsying diseased skin will aid in diagnosing the condition. Unfortunately, other conditions can appear similar, so symptoms and response to medications while waiting for biopsy results (which can take 1-2 weeks) are also needed. Culturing the affected skin (i.e. testing for bacteria) is commonly done to ensure that another type of infection is not occurring.
Affected Breeds
Some breeds may have an increased risk for developing DLE, including:
Dogs of any age or gender can be affected.
Treatment
Antibiotics will likely be started while waiting on biopsy results. The way a dog responds will help the veterinarian determine what disease process is occurring. Topical medications to decrease inflammation and help with discomfort may also be prescribed.
Once DLE is confirmed, immunosuppressive medications such as steroids (e.g. prednisone, cyclosporine) or medications that help regulate the immune system (e.g. niacinamide) may be prescribed. Doses will be adjusted as needed by the veterinarian to ensure the pet is on the lowest effective dose of medication.
Veterinary Cost
Cost depends on which tests are run and which medications are necessary for treatment.
Biopsies can range from $250 to $500 depending on size of the patient and where the biopsy is taken
Culture ranges from $150 to $300
Medications vary widely with patient size and therapy choices but can range from $50 to $300 a month.
Prevention
Nothing can be done to prevent DLE from happening. Some veterinarians recommend avoiding sun exposure as much as possible. Make sure to keep the vet aware if the skin does or does not improve with medications. This will minimize the chance of disease becoming too severe or uncomfortable for the pet.
References
1. Miller WH, Griffin CE, Campbell KL: Muller and Kirk’s Small Animal Dermatology. 7th ed. St Louis: Elsevier 2013.
2. Gross TL, Ihrke PJ, Walder EJ, et al: Skin Diseases of the Dog and Cat: Clinical and Histopathologic Diagnosis. 2nd ed. Ames: Blackwell Science 2005.
3. Jackson H: Update on Canine Cutaneous Lupus Diseases. British Small Animal Veterinary Congress 2007.
4. Banovic F, Olivry T, Linder KE: Ciclosporin therapy for canine generalized discoid lupus erythematosus refractory to doxycycline and niacinamide. Vet Dermatol 2014 Vol 25 (5) pp. 483-e79.
5. Iwasaki T, Shomizu M, Obata H, et al: A canine case of discoid lupus erythematosus with circulating autoantibody. J Vet Med Sci 2199 Vol 57 (6) pp. 1097-1099.
6. Wiemelt SP, Goldschmidt MH, Greek JS, et al: A retrospective study comparing the histopathological features and response to treatment in two canine nasal dermatoses, DLE and MCP. Vet Dermatol 2004 Vol 15 (6) pp. 341-348.
7. Oberkirchner U, Linder KE, Olivry T: Successful treatment of a novel generalized variant of canine discoid lupus erythematosus with oral hydroxychloroquine. Vet Dermatol 2012 Vol 23 (1) pp. 65-e16.
8. Griffies JD, Mendelsohn CL, Rosenkrantz WS, et al: Topical 0.1% tacrolimus for the treatment of discoid lupus erythematosus and pemphigus erythematosus in dogs. J Am Anim Hosp Assoc 2004 Vol 40 (1) pp. 29-41.
9. White SD, Rosychuk RA, Reinke SI, et al: Use of tetracycline and niacinamide for treatment of autoimmune skin disease in 31 dogs. J Am Vet Med Assoc 1992 Vol 200 (10) pp. 1497-1500.